Riding the Next Wave: Implications for Pediatric Care

Background: Our healthcare systems have changed in the face of multiple challenges amidst the first wave of the COVID-19 pandemic. In the literature there are numerous reports of delays in care, with concomitant increases in morbidity and mortality. However, studies assessing and understanding such causative barriers to care from an outpatient pediatric perspective are lacking.

Objective: his study aimed to determine barriers to delivering care from an outpatient pediatric perspective and proposes solutions accordingly.

Methods: We performed a 23 question mixed quantitative and qualitative survey of community pediatricians in Ottawa, Canada, between July 23 and 31, 2020. We received a 57% response rate.

Results: The results indicated that 5 months into the first COVID-19 wave there were mounting wait-times for pediatric patients, that parents were fearful of visiting their healthcare provider and that there were concerns from the provider perspective including outpatient assessment of febrile children, and vaccine delivery. The largest initial barrier to providing in-person care identified in this early survey was access to personal protective equipment wherein the delivery of care was significantly impacted by availability of PPE. This has only worsened as we meet a second wave in tandem with the flu season and return to school for many children. Our survey results also reveal innovative solutions such as drive-through assessments and unique local partnerships to address barriers to care.

Conclusion: Ultimately, findings from this work highlight several significant barriers that continue to challenge the ability for pediatricians to deliver outpatient care. By defining these barriers, and proposing solutions, we can potentially address them in order to mitigate morbidity as it relates to access in care in the context of the pandemic.